The overall goal of this research is to overcome some of the geographical barriers to optimal medical care found in rural areas, by compressing distance using two-way interactive video (telemedicine), creating a "virtual medical center" at two rural study sites. The overall hypothesis for the research is that two-way interactive video (telemedicine) can partially substitute for on-site delivery of oncologic expertise to underserved rural areas. To test the overall hypothesis, five specific hypotheses will be tested, each having a specific aim. The five specific aims are: 1. To determine patient/physician satisfaction with telemedicine, by doing surveys quantifying satisfaction. 2. To determine voluntary patient/physician usage of telemedicine through the use of time logs and measures of utilization. 3. To determine the reliability of telemedicine diagnosis and treatment planning by comparing it to the on-site "gold standard." 4. To determine the efficiency of telemedicine, by formal cost-effectiveness analysis. 5. to determine the impact of telemedicine on the community by assessing quality of life and enrollments into state-of-the-art treatment protocols. This five-year research program will be guided by senior academic mentors and combined with a carefully thought out academic program to upgrade the principal investigator's research skills to the highest level. Thus, this grant will enable two things: 1) thorough exploration and evaluation of an intervention with high potential for improving the cancer care of rural people.. 2) development of a top quality researcher who will be able to design, implement, and analyze cancer control studies, to optimally collaborate with other researchers, and to mentor emerging academic physicians.